GRUPO DENTAL DR.GUALBERTO RABELL
NPI: 1558631630
· SAN JUAN, PR 00920
· Dental Clinic/Center
· NPI assigned 01/06/2012
1,160
Beneficiary Records
Provider Details
| Authorized Official | VEGA DE JESUS, MARITZA (EXECUTIVE SUB DIRECTOR) |
| Parent Organization | CDT DR.GUALBERTO RABELL |
| NPI Enumeration Date | 01/06/2012 |
Related Entities
Other providers sharing the same authorized official: VEGA DE JESUS, MARITZA
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
170 |
$3K |
| 2019 |
825 |
$14K |
| 2021 |
12 |
$159.61 |
| 2022 |
353 |
$6K |
| 2023 |
179 |
$4K |
| 2024 |
98 |
$2K |
Billing Codes
| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
373 |
283 |
$9K |
| D1999 |
|
472 |
385 |
$7K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
273 |
188 |
$5K |
| D1208 |
Topical application of fluoride, excluding varnish |
213 |
131 |
$3K |
| D1120 |
Prophylaxis - child |
138 |
77 |
$2K |
| D0120 |
Periodic oral evaluation - established patient |
79 |
59 |
$907.50 |
| D2150 |
Silver amalgam - two surfaces, primary or permanent |
42 |
12 |
$804.40 |
| D0272 |
Bitewings - two radiographic images |
28 |
12 |
$377.10 |
| D0220 |
Intraoral - periapical first radiographic image |
19 |
13 |
$95.20 |